The Professional Counselor | Volume 13, Issue 2 78 2019). Understanding how weight bias may impact this relationship is vital to building an authentic therapeutic relationship, which may otherwise be hindered by weight bias, which inaccurately frames a counselor’s competence (McKee & Smouse, 1983). Thus, we examined client weight bias toward overweight, underweight, and average-weight counselors in the current study. Literature Review Weight Bias The term weight bias indicates a negative attitude about the perceived weight of an individual (Christensen, 2021). Historically, weight bias has been directed at people perceived as overweight; however, recent evidence suggests that underweight bodies generate weight bias as well (Allison & Lee, 2015; Beggan & DeAngelis, 2015; Christensen, 2021; Davies et al., 2020a, 2020b). Weight bias is pervasive throughout the United States (McHugh & Kasardo, 2012; Puhl et al., 2014). Negative stereotypes associated with being overweight include laziness, lack of motivation, psychological instability, social rejection, and incompetence in the workforce (Hinman et al., 2015; Lewis et al., 1997; Moller & Tischner, 2019). Likewise, incorrect stereotypes about underweight people include psychological instability or weakness (Marini, 2017). Body weight is not explicitly identified as an issue in the multicultural and social justice competencies (Ratts et al., 2016). However, weight bias is similar to sexism, racism, and classism in its harmful impact on people (Bucchianeri et al., 2013). It is still a common form of prejudice (McHugh & Kasardo, 2012). Weight bias has become a social justice issue because of how it negatively impacts the lived experiences of people across social contexts (Nutter et al., 2018). Similar to other identities that elicit prejudice, weight bias impacts an individual’s opportunities in the workforce (Hutson, 2013), quality of mental health care (Puhl et al., 2014), and interpersonal relationships (Puhl & Heuer, 2010). Oppression from weight bias may deter a person from forming relationships or making connections with others out of fear of rejection or discrimination based on weight. Likewise, a person with weight bias may struggle to overlook the body of their counselor because of their worldview of weight and health. Even if the client remains in counseling, this initial bias may impede the therapeutic alliance process. Therapeutic Alliance The therapeutic alliance is a key variable in predicting client outcomes in counseling (Ackerman & Hilsenroth, 2001). This alliance represents the degree to which the client and counselor are engaged in collaboration, their commitment to one another, and their understanding of the counseling process (Allen et al., 2017; Lorr, 1965). Clients are as important as counselors in building this alliance, which involves their impression of and reaction to the counselor (Tudor, 2011). Disruptions in the therapeutic alliance can be generated from the client’s adverse reaction to the counselor, which thus impacts client outcomes (Ackerman & Hilsenroth, 2001). Weight can be a disruption, as some clients see a counselor being overweight as a barrier to opening up and engaging in counseling (Moller & Tischner, 2019). As the therapeutic alliance impacts clients remaining in counseling (Sharf et al., 2010), biases toward the counselor may hinder building the relationship, leading to early termination. Clients discriminating against counselors may limit capable counselors who fall outside socially acceptable weights from co-building the therapeutic alliance (McKee & Smouse, 1983). Even with weight bias possibly diminishing the initial therapeutic relationship, Allen et al. (2017) found that communication on tasks/goals was a predictor of a strong therapeutic alliance and activation (i.e., the clients’ readiness and willingness to take on the management of their mental
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